Nokea
A 12-year-old child is injured in a bicycle accident. When considering the possibility of renal trauma, the nurse should consider what factor?
- A. Flank pain rarely occurs in children with renal injuries.
- B. Few nonpenetrating injuries cause renal trauma in children.
- C. Kidneys are immobile, well protected, and rarely injured in children.
- D. The amount of hematuria is not a reliable indicator of the seriousness of renal injury.
Correct Answer: D
Rationale: Hematuria is common in renal trauma but doesn?t correlate with injury severity. Flank pain often occurs due to bleeding, most renal trauma in children is from blunt injuries like accidents, and children?s kidneys are more mobile and less protected, increasing injury risk.
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A child is admitted for minimal change nephrotic syndrome (MCNS). The nurse recognizes that the childs prognosis is related to what factor?
- A. Admission blood pressure
- B. Creatinine clearance
- C. Amount of protein in urine
- D. Response to steroid therapy
Correct Answer: D
Rationale: Response to steroid therapy within 28 days predicts prognosis in MCNS; non-response reduces likelihood of remission. Blood pressure is typically normal, creatinine clearance isn?t prognostic, and proteinuria confirms diagnosis but doesn?t predict outcome.
The nurse is teaching a client to prevent future urinary tract infections (UTIs). What factor is most important to emphasize as the potential cause?
- A. Poor hygiene
- B. Constipation
- C. Urinary stasis
- D. Congenital anomalies
Correct Answer: C
Rationale: Urinary stasis is the primary host factor promoting UTIs by providing a bacterial growth medium. Poor hygiene and constipation contribute by facilitating bacterial entry or causing stasis via rectal pressure, but stasis is the key driver. Congenital anomalies are less common causes.
What is the primary objective of care for the child with minimal change nephrotic syndrome (MCNS)?
- A. Reduce blood pressure.
- B. Lower serum protein levels.
- C. Minimize excretion of urinary protein.
- D. Increase the ability of tissue to retain fluid.
Correct Answer: C
Rationale: The primary goal in MCNS is to minimize urinary protein excretion, reducing edema and complications. Blood pressure is typically normal, serum protein levels need to increase, and fluid retention (edema) is a problem to be reduced, not increased.
What name is given to inflammation of the bladder?
- A. Cystitis
- B. Urethritis
- C. Urosepsis
- D. Bacteriuria
Correct Answer: A
Rationale: Cystitis is inflammation of the bladder, often due to infection. Urethritis affects the urethra, urosepsis is a systemic infection from the urinary tract, and bacteriuria indicates bacteria in urine without necessarily implying inflammation.
What measure of fluid balance status is most useful in a child with acute glomerulonephritis?
- A. Proteinuria
- B. Daily weight
- C. Specific gravity
- D. Intake and output
Correct Answer: B
Rationale: Daily weight is the most accurate measure of fluid balance in acute glomerulonephritis, reflecting edema changes. Proteinuria indicates disease severity, specific gravity is unreliable due to proteinuria and hematuria, and intake/output is less accurate, especially in non-toilet-trained children.